Fraser Health cuts surgeries to make budget

Fraser Health has curtailed surgeries in order to avoid an operating room budget overrun despite the fact surgical wait times at its hospitals are already significantly longer than for patients in the neighbouring Vancouver Coastal region.

Dr. Peter Blair, director of the surgical program for Fraser Health, said the reduction of surgeries since January and February was "only by a few per cent" and not the 20 per cent cut a White Rock orthopedic surgeon claimed last week.

Blair said he's hopeful Fraser will soon be granted a budget increase allowing more surgeries, but said the curtailed surgical pace is continuing for now.

It's not a budget cut, he said, but a reduction in actual surgeries performed to bring OR spending back down to budgeted levels.

"We realized we were spending money faster than we could," Blair said of the overspending in the first two months of the year. "We did need to make a significant reduction."

The department has since finished the fiscal year at the end of March within its budget.

Asked if averting a deficit has driven up wait times, Blair said he hasn't yet seen any clear evidence of that yet.

But surgical wait time data reported by the provincial government shows patients at most hospitals in Fraser are already waiting considerably longer than those near Vancouver or most other parts of B.C.

(See wait times chart below story)

The two benchmarks the province uses to gauge surgical waits is how long it takes to complete 50 per cent of cases and 90 per cent of cases in each hospital, specialty or region.

For the first three months of 2014 until March 31, Fraser completed half its surgeries within 6.4 weeks – the other half of patients waited longer than that – compared to 5.1 weeks at Vancouver Coastal and 6.0 weeks for the B.C. average.

Ninety per cent of surgeries performed in those months at Fraser waited less than 31.3 weeks (10 per cent waited longer), compared to 23 weeks for Vancouver Coastal and 28.3 weeks for the provincial average.

That indicates patients in Fraser waited 25 to 35 per cent longer than in Vancouver Coastal in January to March, even though two of those three months saw Fraser's ORs running over-budget before being curtailed.

"All of us have to be concerned about that," Blair said of the wait time disparity.

He cited population growth as the main challenge making it difficult to meet wait time targets.

"We're the fastest growing health authority in British Columbia – 1,200 people a month are moving into Surrey alone," Blair said. "We've got the highest birth rate and a high rate of people moving in as retirees into places like White Rock."

He noted surgical waits vary by hospital, by specialty and by individual doctor.

The Lower Mainland hospitals with the worst surgical waits in the first three months of the year were Burnaby Hospital at 47.7 weeks to reach the 90 per cent completion mark, Abbotsford Regional at 39.2 weeks, 36.9 weeks for Langley Memorial, 36.7 weeks for B.C. Children's, 35.7 weeks for Peace Arch and 35 weeks for Surrey Memorial.

As of March 31, Fraser hospitals had 20,233 patients awaiting surgeries, compared to 17,389 at Vancouver Coastal.

A report released in February by B.C.’s auditor general showed Fraser Health has the lowest per capita funding per year in B.C. at $1,585 (in 2011-12) – in comparison with Vancouver Coastal Health, which received $3,008 per capita. Vancouver Island Health received $2,554, Northern Health received $2,465 and Interior Health received $2,372.

Blair said the action to rein in surgeries was a decision of the region's surgeons, who met to review the threatened deficit.

He said it was not related to a strategic and operational review into Fraser Health ordered late last year by Health Minister Terry Lake to unravel why the health region has struggled to stay within its budget allocations.

– with files from Alex Browne

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